Radiation therapy of choroidal melanoma: comparative evaluation of the treatment results

Abstract

Objectives. To conduct a systematic review of the application results of various methods of radiation therapy for choroidal melanoma treatment, as well as to compare the results of stereotactic radiosurgery and brachytherapy application for the choroidal melanoma treatment in a monocenter study. Material and methods. As a part of systematic review, publications for analysis were searched for in the PubMed database using the queries “Brachytherapy and uveal melanoma or choroid melanoma”, “Proton therapy and uveal melanoma or choroid melanoma”, “Stereotactic radiosurgery and uveal melanoma or choroid melanoma” over the past 5 years. The review included 38 publications. The monocentric clinical study of prospective stereotactic radiosurgery group included 61 patients who were diagnosed with choroidal melanoma cT1-4N0M0. The historical control group consisted of patients with comparable tumor size who underwent brachytherapy (55 patients). Comparative analysis of local control levels, overall survival, progression-free survival, and complication rate was made. Results. Two-year disease-free survival in the stereotactic radiosurgery group was 95.2±4.6%, in the brachytherapy group it made up 63.9±6.1% (p log-rank = 0.001). Complications in the stereotactic radiosurgery group were registered in 33 (44.0%) cases, in the brachytherapy group – in 14 (22.9%) cases (p=0.027). The level of eyeball preservation within two years after treatment was 84.0±6.1% and 82.0±4.9% after stereotactic radiosurgery and brachytherapy, respectively (p log-rank=0.93). Conclusions. The results of the stereotactic radiosurgery application for the treatment of choroidal melanoma are not inferior in terms of efficacy and safety to brachytherapy.

Keywords

• choroidal melanoma
• stereotactic radiosurgery
• brachytherapy
• radiation therapy
• disease-free survival